Priya P Patel, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA55343 Issued in CA

Practice address

1505 Wilson Ter Ste 240
Glendale, CA 91206-4033

Phone

(310) 205-3555

Fax

(310) 205-3553

NPI assigned

Aug 2, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• All About Kids and Family Medical Center Inc

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1750476065
  NPD (past)
• Ellis Pediatrics, PLLC

  • Pediatrics Physician
  • Jacksonville, FL
  • NPI 1134844426
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1730467143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 MONTANA AVE STE 912",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904031652",
            "telephone_number": "310-205-3555",
            "fax_number": "310-205-3553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 WILSON TER STE 240",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064033",
            "telephone_number": "310-205-3555",
            "fax_number": "310-205-3553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12086 Fort Caroline Rd",
            "address_2": "Suite 401",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322252687",
            "country_code": "US",
            "telephone_number": "904-565-1271",
            "fax_number": "904-645-7325",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16030 Ventura Blvd Ste 140",
            "address_purpose": "LOCATION",
            "city": "Encino",
            "state": "CA",
            "postal_code": "914364453",
            "country_code": "US",
            "telephone_number": "310-205-3555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "PRIYA",
        "middle_name": "P",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-02",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "FL",
            "license": "PA9105796",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004345000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rommel Lato Pastor, RDA
• Patao Dental Corporation (Derek Patao DDS)
• Derek Henry Patao, DDS
• Ami N Patel, M.D.
• Neha Patel
• Rupeshbhai A. Patel, D.C.
• Sameer A Patel, M.D.
• Seema Dilipkumar Patel, PHARMD
• Sheevam Patel, RPH
• Soma Pathak, M.D.

• Physician Assistant in Glendale, CA
• Providers in Glendale, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.